What is the Goal?

A person asked me the other day “What is the goal?”  Is it to have each day consumed with taking meds, going to appointments and doing things to stave off depression and prevent a recurrence?   To have as your only social contacts people with whom you can discuss your depression at length, such as those in a support group?  That seems to me to be both overwhelming and forgetful of the rest of your life.

Or is it to take meds and go to appointments some times when you are feeling ill, and then stop taking them when you feel better.  “I don’t need meds”.  “I don’t like taking meds”.  I do not see the logic in that.  It is sure to set you up for an emotional roller coaster with your illness.  It would bring on more hardship than you would otherwise have.

Or is the goal to do nothing, say nothing to your friends, family, providers, receive no treatment, and suffer quietly until you can no longer bear it. Assume that you recover from this untreated episode.  Research studies have shown that each time you have an episode of depression you are at risk for even more episodes.  So it is in your best interest to receive treatment for the illness.

I believe that answer to the question “what is the goal” is the following.  The ultimate goal is to manage the symptoms of depression so well each day that they do not interfere with your ability to participate in your usual life.  Following the guidelines will then enable you to enjoy as best as possible the company of friends and activities and not have depression enter into the conversation, except as a brief but concerned “How’re you doin’”.  When you can manage your depression in a way such that you can function pretty well, work, go to school, get out and have a dinner out, a bike ride or a hike without making the illness the focus of your thoughts or conversation at every moment, then that is a success.  It does not dismiss the severity of your depression.  The illness is still there and you need to manage it.  You do this in conjunction with your health care provider, using Cognitive Behavior Therapy exercises and by following the Basics of Mental Health (sleep hygiene, diet and nutrition, daily routine and structure, daily exercise, avoid isolation, etc.).  And you know that your family and friends know about your illness and care about you.  The ultimate goal is to manage it so well that you will be able to engage in your life and not have depression consume your every moment.

Stay well!